1
|
Abstract
Kingella kingae is the leading cause of osteoarticular infections between 6 and 48 months, a well-known cause of pediatric bacteremia and endocarditis and has been rarely associated with meningitis. We report a case of a healthy 10-year-old boy with meningitis due to Kingella kingae who presented with a history of severe headache, vomiting and prostration.
Collapse
Affiliation(s)
- Madalena Almeida Borges
- From the Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, EPE
- Pediatrics Department, Hospital da Criança e do Adolescente, Hospital da Luz Lisboa
| | - Sara Silva
- Pediatrics Department, Hospital da Criança e do Adolescente, Hospital da Luz Lisboa
| | - Raquel Ferreira
- Pediatrics Department, Hospital da Criança e do Adolescente, Hospital da Luz Lisboa
| | - Catarina Martins
- CHRC, CEDOC, Chronic Diseases Research Center, NOVA Medical School
| | - Paulo Paixão
- Clinical Pathology Laboratory (Synlab), Hospital da Luz Lisboa
- CEDOC, Chronic Diseases Research Center, NOVA Medical School
| | | | - João Farela Neves
- Pediatrics Department, Hospital da Criança e do Adolescente, Hospital da Luz Lisboa
- CEDOC, Chronic Diseases Research Center, NOVA Medical School
| |
Collapse
|
2
|
Villani MC, Hamilton EC, Klosterman MM, Jo C, Kang LH, Copley LAB. Primary Septic Arthritis Among Children 6 to 48 Months of Age: Implications for PCR Acquisition and Empiric Antimicrobial Selection. J Pediatr Orthop 2021; 41:190-196. [PMID: 33417393 DOI: 10.1097/bpo.0000000000001744] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Primary septic arthritis requires unique evaluation and treatment considerations for children in the 6- to 48-month age range because of the spectrum of identified pathogens and high rate of negative cultures. The purpose of this study is to evaluate primary septic arthritis in this age group in order to differentiate children with infection caused by Kingella kingae from those with other confirmed pathogens and those with no identified pathogen. METHODS Preschool children who underwent multidisciplinary evaluation and treatment for septic arthritis between 2009 and 2019 were retrospectively studied. Three cohorts were established for comparison of clinical and laboratory features of primary septic arthritis: (1) confirmed K. kingae, (2) confirmed other pathogen, and (3) presumed (without identified pathogen). RESULTS Among 139 children with septic arthritis, 40 (29%) were confirmed K. kingae, 29 (21%) other pathogen, and 70 (50%) presumed. Children with Kingella and those with presumed septic arthritis had significantly lower initial C-reactive protein (4.8 and 4.5 vs. 9.3 mg/dL) and fewer febrile hospital days (0.2 and 0.4 vs. 1.3 d) than children with other confirmed pathogens. Children with other pathogens had higher rates of bacteremia (38% vs. 0%) and positive joint fluid cultures (86% vs. 15%) than that of children with Kingella. The rate of polymerase chain reaction (PCR) acquisition was 38 of 40 (95.0%) Kingella cases, 18 of 29 (62.1%) other pathogen cases, and 33 of 70 (47.1%) presumed cases. CONCLUSIONS K. kingae was the most commonly identified pathogen among 6-month to 4-year-old children. The Kingella and other identified pathogens in this study serve to guide empiric antimicrobial recommendations for this age range. Because of similarities between children with septic arthritis because of K. kingae and those with no identified pathogen, it is likely that an unrecognized burden of Kingella resides in culture negative cases, particularly if no PCR is sent. Systematic evaluation, including PCR acquisition, and a high index of suspicion for K. kingae are recommended to thoroughly evaluate septic arthritis in preschool children. LEVEL OF EVIDENCE Level III-Retrospective cohort comparison.
Collapse
Affiliation(s)
| | | | | | - Chanhee Jo
- Texas Scottish Rite Hospital for Children
| | - Lisa H Kang
- Department of Radiology, UC Davis, Sacramento, CA
| | - Lawson A B Copley
- Children's Health System of Texas
- Texas Scottish Rite Hospital for Children
- Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX
| |
Collapse
|
3
|
夏 耀, 马 莉, 邱 向, 李 贵, 郭 映, 刘 淑, 蒲 伟, 王 乐. [Early-onset septic shock in a preterm infant caused by Kingella Kingae]. Zhongguo Dang Dai Er Ke Za Zhi 2020; 22:804. [PMID: 32669182 PMCID: PMC7389623 DOI: 10.7499/j.issn.1008-8830.2004069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Affiliation(s)
- 耀方 夏
- 河北省儿童医院新生儿科, 河北 石家庄 050031Department of Neonatology, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei 050031, China
| | - 莉 马
- 河北省儿童医院新生儿科, 河北 石家庄 050031Department of Neonatology, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei 050031, China
| | - 向利 邱
- 河北省儿童医院新生儿科, 河北 石家庄 050031Department of Neonatology, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei 050031, China
| | - 贵霞 李
- 河北省儿童医院检验科, 河北 石家庄 050031
| | - 映辉 郭
- 河北省儿童医院检验科, 河北 石家庄 050031
| | - 淑华 刘
- 河北省儿童医院新生儿科, 河北 石家庄 050031Department of Neonatology, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei 050031, China
| | - 伟丛 蒲
- 河北省儿童医院新生儿科, 河北 石家庄 050031Department of Neonatology, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei 050031, China
| | - 乐 王
- 河北省儿童医院儿科研究所, 河北 石家庄 050031
| |
Collapse
|
4
|
Huard A, Van Fraechem G, Gerain J, Van Hove M, Cosyns B. [Kingella kingae septicemia in a patient with coxsackievirus infection]. Rev Med Brux 2016; 37:419-422. [PMID: 28525210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Kingella kingae is a gram-negative cocci present in the oral flora ; this organism is difficult to isolate by conventional culture techniques ; it can be detected after longer incubation period (more than 6 days) in blood culture. It is responsible of various infectious diseases, especially in children below 3 years-old where it is a cause of arthritis and osteomyeli tis. It is included in HACEK organisms responsible of 2 to 3 % of all cases of native endocarditis. The case report is the case of a young women with Kingella kingae septicemia in a context of oral lesions from Coxsackie virus infection ; treatment by ciprofloxacine permit a complete resolution of symptoms. Differential diagnosis is made about conditions with oral lesions. This article is an occasion to review literature about this unusual organism and clinical presentation. Improvements in laboratory method will in the future increase incidence and prevalence of infections caused by Kingella kingae.
Collapse
Affiliation(s)
- A Huard
- Hôpital de Braine-l'Alleud, Waterloo Service de Médecine Interne et Endocrinologie, Rue Wayez 35, Braine-l'Alleud, Belgium
| | - G Van Fraechem
- Service de Maladies Infectieuses et Médecine Tropicale, Belgium; Gerain, J., Clinique Du Parc Léopold, Service de Maladies Infectieuses, Belgium
| | - J Gerain
- Clinique Du Parc Léopold, Service de Maladies Infectieuses, Belgium
| | - M Van Hove
- Médecine d'Urgence et Soins Intensifs, CHIREC, Belgium
| | - B Cosyns
- Hôpital de Braine-l'Alleud/Waterloo, Belgium
| |
Collapse
|
5
|
Ruttan TK, Higginbotham E, Higginbotham N, Allen CH, Hauger S. Invasive Kingella kingae Resulting in a Brodie Abscess. J Pediatric Infect Dis Soc 2015; 4:e14-6. [PMID: 26407421 DOI: 10.1093/jpids/piu046] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 04/28/2014] [Indexed: 11/14/2022]
Affiliation(s)
- Timothy K Ruttan
- Department of Pediatric Emergency Medicine, Dell Children's Medical Center of Central Texas, Austin, United States
| | - Eric Higginbotham
- Department of Pediatric Emergency Medicine, Dell Children's Medical Center of Central Texas, Austin, United States
| | - Nicole Higginbotham
- Department of Neurosurgery, Dell Children's Medical Center of Central Texas, Austin, United States
| | - Coburn H Allen
- Departments of Pediatric Emergency Medicine and Pediatric Infectious Diseases, Dell Children's Medical Center of Central Texas, Austin, United States
| | - Sarmistha Hauger
- Department of Pediatric Infectious Diseases, Dell Children's Medical Center of Central Texas, Austin, United States
| |
Collapse
|
6
|
Abstract
As the result of improved bacteriological techniques, Kingella kingae is emerging as an important cause of infections of the skeletal system in children younger than 2 years of age. This review details the bacteriological features and detection methods of this pathogen, as well as the epidemiology, clinical presentation, treatment and prognosis of septic arthritis, osteomyelitis and diskitis caused by the organism.
Collapse
Affiliation(s)
- Pablo Yagupsky
- Soroka University Medical Center, Clinical Microbiology Laboratories, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel.
| |
Collapse
|
7
|
Otuonye NM, Odunukwe NN, Idigbe EO, Imosemi OD, Smith SI, Chigbo RC, Bamidele M, Oparaugo CT, Mafe AG, Musa AZ. Aetiological agents of vaginitis in Nigerian women. Br J Biomed Sci 2007; 61:175-8. [PMID: 15649008 DOI: 10.1080/09674845.2004.11732666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study focuses on the identification of aetiological agents of vaginitis in Nigerian women. Study subjects are drawn from patients presenting with lower abdominal pain, vaginal discharge and itching at the gynaecology clinic of Lagos University Teaching Hospital and at the Clinical Centre of the Nigerian Institute of Medical Research, Yaba, Lagos, between January 2001 and July 2002. A total of 250 patients gave informed consent to participate in the study. The patients also had pre- and post-test human immunodeficiency virus (HIV) counselling. Each patient completed a questionnaire in order to provide biographical data, past clinical history and socio-economic background information. A cervical swab (CS) and a high-vaginal swab (HVS) were obtained from each patient. Swab samples were examined for pH and under light microscopy by Gram's stain and as wet preparations in 10% potassium hydroxide. Subsequently, samples were cultured on appropriate media at optimal conditions and a drug sensitivity profile for all isolates was determined by standard methods. Blood samples were screened and confirmed for HIV antibodies. Bacterial, fungal and parasitic pathogens were identified or isolated in samples from 241 (96.4%) of the women. Bacterial agents (Neisseria, Streptococcus and Staphylococcus species) were predominant in 128 (51.2%) patients, followed by fungi in 108 (43.2%) and parasites (Trichomonas vaginalis) in five (2.0%). Sensitivity to ciprofloxacin was seen in 40% of Staphylococcus species and in 90% of Neisseria species. Positive HIV serology was seen in 25 (10%) of the 250 women studied, 20 (80%) of which had concurrent microbial infections. Overall, a broad spectrum of microbial agents were shown to be responsible for vaginitis in the group of patients studied.
Collapse
Affiliation(s)
- N M Otuonye
- Molecular Biology and Biotechnology, Nigerian Institute of Medical Research, P.M.B 2013, Yaba, Lagos, Nigeria.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Kamar N, Chabbert V, Ribes D, Chabanon G, Faguer S, Mari A, Guitard J, Durand D, Rostaing L. Neisseria-cinerea-induced pulmonary cavitation in a renal transplant patient. Nephrol Dial Transplant 2007; 22:2099-100. [PMID: 17389625 DOI: 10.1093/ndt/gfm040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
9
|
Abstract
We report a case of infective endocarditis (IE) caused by an unusual micro-organism in a previously healthy young man. Our patient presented with meningo-encephalitis and embolic signs due to IE caused by Neisseria sicca. Risk factors for IE due to Neisseria sicca, such as intravenous drug use and pre-existing heart disease were absent. The patient recovered well after mitral valve surgery and antimicrobial therapy. IE due to Neisseria spp. is associated with embolic manifestations and valve destruction. However, no deaths have been reported in patients who are treated with appropriate antimicrobial and surgical therapy.
Collapse
Affiliation(s)
- A Jeurissen
- Laboratory of Microbiology and Infection Control, Amphia Hospital, Breda, The Netherlands
| | | | | | | |
Collapse
|
10
|
Elyès B, Mehdi G, Kamel BHS, Hela Z, Imen BS. Kingella kingae septic arthritis with endocarditis in an adult. Joint Bone Spine 2006; 73:472-3. [PMID: 16807042 DOI: 10.1016/j.jbspin.2005.10.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2005] [Accepted: 10/04/2005] [Indexed: 11/20/2022]
Abstract
Kingella kingae is part of the nonpathogenic flora normally found in the oral cavity and pharynx. Recent reports have established that K. kingae can cause invasive infections in pediatric patients. Few cases have been described in adults, however. We report a case of K. kingae arthritis of the knee followed by endocarditis in a 59-year-old woman. Physicians and microbiologists should be alert to the possibility of K. kingae infection. K. kingae is easy to detect provided its specific culture requirements are taken into account. Synovial fluid inoculation into blood culture vials considerably increases the likelihood of K. kingae recovery in patients with septic arthritis.
Collapse
Affiliation(s)
- Bouajina Elyès
- Rheumatology Department, Farhat Hached Teaching Hospital, 4000 Sousse, Tunisia.
| | | | | | | | | |
Collapse
|
11
|
Bauer A, Jabs WJ, Süfke S, Maass M, Kreft B. Vasculitic purpura with antineutrophil cytoplasmic antibody-positive acute renal failure in a patient with Streptococcus bovis case and Neisseria subflava bacteremia and subacute endocarditis. Clin Nephrol 2005; 62:144-8. [PMID: 15356972 DOI: 10.5414/cnp62144] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Subacute bacterial endocarditis is frequently associated with extracardiac manifestations and renal failure. Clinical variety of endocarditis manifestation is wide and has the potential to mimic vasculitis. Whereas Streptococcus bovis is often isolated and associated with colonic tumors, Neisseriaceae are rarely found. An association of subacute bacterial endocarditis and antineutrophil cytoplasmic antibodies has been described. We report on a 62-year-old man who was admitted to our hospital with acute oliguric renal failure and a nonpruritic purpural rush without fever. Antineutrophil cytoplasmic antibody diagnostic revealed perinuclear staining with a titre of 1 : 512 and antiproteinase-3 specificity. Immune complex-mediated glomerulonephritis without extracapillary proliferation was diagnosed in renal biopsy. Finally, blood cultures became positive for Streptococcus bovis and Neisseria flava. Echocardiography showed mobile vegetations on tricuspid valve. Under treatment with penicillin G and gentamicin, skin efflorescences and renal function recovered, but vegetations increased. A colonic tumor could be excluded, a disastrous dental status may have been a predisposal factor. When classical findings of subacute bacterial endocarditis are less clear, the presence of renal failure and antineutrophil cytoplasmic antibodies in absence of fever may lead to misdiagnosis and deleterious immunosuppressive therapy. Neisseria subflava, an upper respiratory tract commensal, may cause subacute bacterial endocarditis without typical symptoms.
Collapse
Affiliation(s)
- A Bauer
- Department of Medicine I, University of Lübeck School of Medicine, Lübeck, Germany.
| | | | | | | | | |
Collapse
|
12
|
Gajda M, Holzhausen HJ, Gudziol S, Hauptmann S, Bloching M. [Necrotizing fasciitis of the head and neck]. Otolaryngol Pol 2005; 59:831-5. [PMID: 16521446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Necrotizing fasciitis (NF) is a potentially lethal soft tissue infection characterized by cutaneous necrosis, suppurative fasciitis, vascular thrombosis and extreme systemic toxicity. It is a rare entity in the head and neck region, but occur most frequently in patients with diabetes and chronic alcoholism. Mostly involved are immunodeficient patients with banal infections of the upper aerodigestive tract, small traumas, but also after surgical procedures. Necrotizing fasciitis is an infection caused by aerobic or anaerobic microorganisms. A strong complication is a streptococcus-associated-toxic shock-syndrome which should be prevented because it is often associated with letal outcome. Septicemia and systemic toxic effects may lead to death within as short a time as 2 to 4 days. Necrotizing fasciitis is often misdiagnosed or the diagnosis is delayed with a mortality rate of approximately 30-70%. Once identified, treatment consists of antimicrobial therapy and surgical debridement followed at a later date with reconstructive surgery. We present a fatal case of craniofacial necrotizing fasciitis (NF) in a 63-year-old diabetic and chronic alcoholic man and discuss it's pathophysiology, clinical manifestations and the best therapeutic choice for this disease. A review of the literature with the clinical presentations, bacteriology diagnosis and treatment was presented.
Collapse
|
13
|
Muñoz Morente A, Barón Ramos MA, Mateos Fernández S, López Palmero S, Villar Jiménez J, Regueira Iglesias JM. [Anticoagulation with bemiparina after intracerebral hemorrhage as complication of bacterial endocarditis on metallic prosthetic valve]. An Med Interna 2004; 21:551-3. [PMID: 15538906 DOI: 10.4321/s0212-71992004001100007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We present the case of a patient with an intracerebral hemorrhage as complication of an infectious endocarditis (EI) produced by Neisseria sicca on a prosthetic mitral valve. The patient was anticoagulated previously with Acenocumarol as prophylaxis of thrombosis of the prosthetic valve. He was diagnosed as having IE and later he presented neurological symptoms as consequence of several intracerebral hemorrhagic foci. We decided to continue the anticoagulation with sodium heparin followed of Bemiparina and no new hemorrhagic complications nor thrombosis of the valve were observed after three months of the event. We have not found in the literature any case where low molecular weight heparin has been used as method of anticoagulation in these cases beyond two weeks.
Collapse
Affiliation(s)
- A Muñoz Morente
- Servicio de Medicina Interna, Hospital Regional Carlos Haya, Málaga, Spain.
| | | | | | | | | | | |
Collapse
|
14
|
Gauthier M, Chevalier I, Tapiero B. Henoch-Schonlein purpura associated with Kingella kingae bacteremia. Acta Paediatr 2004; 93:717-8. [PMID: 15174803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
|
15
|
Affiliation(s)
- Allison Brachlow
- Department of Pediatrics, Inova Fairfax Hospital for Children, Virginia, USA
| | | | | |
Collapse
|
16
|
Centers for Disease Control and Prevention (CDC). Osteomyelitis/septic arthritis caused by Kingella kingae among day care attendees--Minnesota, 2003. MMWR Morb Mortal Wkly Rep 2004; 53:241-3. [PMID: 15041952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Kingella kingae is a fastidious gram-negative coccobacillus that colonizes the respiratory and oropharyngeal tract in children. K. kingae occasionally causes invasive disease, primarily osteomyelitis/septic arthritis in young children, bacteremia in infants, and endocarditis in school-aged children and adults. Although diagnosis of this organism frequently is missed, invasive disease is uncommon. Only sporadic, non-epidemiologically linked cases have been reported previously. In October 2003, the Minnesota Department of Health (MDH) investigated a cluster of two confirmed cases and one probable case of osteomyelitis/septic arthritis caused by K. kingae among children aged 17-21 months attending the same toddler classroom in a day care center. All reported within the same week with onset of fever, preceding or concurrent upper respiratory illness (URI), and refusal to bear weight on the affected limb. This report summarizes these cases and describes the epidemiologic investigation of the day care center. The findings underscore the need for clinicians and laboratorians to consider K. kingae infection in young children with Gram stain--negative or culture-negative skeletal infections.
Collapse
|
17
|
Yagupsky P, Press J. Arthritis following stomatitis in a sixteen-month-old child. Pediatr Infect Dis J 2003; 22:573-4, 576-7. [PMID: 12828161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Affiliation(s)
- Pablo Yagupsky
- Clinical Microbiology Laboratory, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | |
Collapse
|
18
|
Lee WC, Yang WC, Chen TW, Huang CH, Lin CC. Unusual presentation of Neisseria mucosa peritonitis with persistent ultrafiltration failure and clear effluent. Perit Dial Int 2003; 23:198-9. [PMID: 12713091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
|
19
|
Abstract
Reported here is a case of infective endocarditis caused by the saprophytic species Neisseria cinerea. To the best of our knowledge, this etiology has not been documented in the medical literature previously. The patient was an intravenous drug addict who developed tricuspid endocarditis with lung embolism. The disease was cured after treatment with ampicillin/clavulanate that was changed to ceftriaxone after an embolic event.
Collapse
Affiliation(s)
- J Benes
- Department of Infectious Diseases, 3rd Faculty of Medicine, Charles University, Ruska 87, 10000 Prague, Czech Republic.
| | | | | | | |
Collapse
|
20
|
Karunakaran R, Ngeow YF, Mashor M. Isolation of Neissseria meningitidis from an unusual site. Malays J Pathol 2002; 24:103-5. [PMID: 12887169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
A 59-year-old post-menopausal lady who had returned from a pilgrimage to Mecca about a month earlier presented with a three days' history of profuse vaginal discharge. Neissseria meningitidis was isolated from high vaginal swab specimens taken from her on 2 occasions, five days apart. Her symptoms disappeared without treatment after two weeks. We conclude that although the organism may have been a colonizer, it is possible that it was responsible for the self-limiting genital infection in this patient.
Collapse
Affiliation(s)
- Rina Karunakaran
- Department of Medical Microbiology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
| | | | | |
Collapse
|
21
|
|
22
|
Bernstein JM, Dryja D, Murphy TF. Molecular typing of paired bacterial isolates from the adenoid and lateral wall of the nose in children undergoing adenoidectomy: implications in acute rhinosinusitis. Otolaryngol Head Neck Surg 2001; 125:593-7. [PMID: 11743458 DOI: 10.1067/mhn.2001.120232] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Recent studies have suggested that the origin of bacteria that enter the lateral wall of the nose and paranasal sinuses arise from the nasopharynx. The purpose of this study was to compare the molecular biological profiles of potential pathogens found in the nasopharynx and lateral wall of the nose concomittantly in children undergoing surgery for upper respiratory tract disease. STUDY DESIGN AND SETTING Fifty-two children undergoing adenoidectomy for either tonsillectomy or adenoidectomy (hypertrophy) or otitis media with effusion were studied. Bacterial cultures were taken from the crypts of the adenoids and from the lateral wall of the nose under endoscopic control after sterilization of the vestibule and inferior turbinate. Routine cultures of these areas were performed in the bacteriology laboratory of the Children's Hospital of Buffalo. RESULTS Bacterial pathogens were isolated from 79% of adenoids and 46% of lateral walls of the nose. Molecular typing of pairs of nontypable Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis revealed that in 16 of 18 pairs (89%) the identical strain was present in both sites simultaneously. CONCLUSIONS These results support the concept that when potential bacterial pathogens that may cause acute bacterial rhinosinusitis are found concomitantly in the nasopharynx and lateral wall of the nose, they are usually identical.
Collapse
Affiliation(s)
- J M Bernstein
- Department of Otolaryngology, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, NY, USA.
| | | | | |
Collapse
|
23
|
Abstract
We describe a 4-year-old boy with Cornelia de Lange syndrome who died of septic shock caused by Moraxella catarrhalis bacteremia. At autopsy there was evidence of acute hemorrhagic pancreatitis with abscesses. Gram-negative diplococci were seen histologically in the abscesses and pancreatic ducts.
Collapse
Affiliation(s)
- K Ohkusu
- Division of Clinical Laboratory, Chiba Children's Hospital, Chiba-city, Japan.
| | | | | | | |
Collapse
|
24
|
|
25
|
Affiliation(s)
- M B Lewis
- Leeds General Infirmary, Great George Street, Leeds LS1 3EX, England.
| | | |
Collapse
|
26
|
Abuamara S, Louis JS, Guyard MF, Barbier-Frebourg N, Tocques S, Lechevallier J, Mallet E. [Kingella kingae osteoarticular infections in children. A report of a series of eight new cases]. Arch Pediatr 2000; 7:927-32. [PMID: 11028199 DOI: 10.1016/s0929-693x(00)90005-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED Kingella kingae is a Gram-negative bacillus which belongs to the Neisseriaceae family. Its involvement in osteoarticular infections is relatively recent. METHODS AND RESULTS We report eight cases of Kingella kingae osteoarticular infections that have been diagnosed at the paediatric surgical centre of Rouen University Hospital since October 1995. Six boys and two girls (mean age: 30.6 months) presented with osteomyelitis in six cases and arthritis in two. Only 75% of patients had a fever at time of diagnosis. The biological findings were slightly modified. All samples were obtained from blood, bone or joint fluid. These samples were systematically inoculated into a blood culture tube. Positive Kingella kingae culture was achieved in seven local samples and in one blood culture. All children received two antibiotics via intravenous injection while waiting for the bacteriologic results. Later, the antibiotic treatment (amoxycillin) was given per os. The mean duration of treatment was 33 days. Patients were given intravenous treatment for a period of only ten days. Six patients were followed up for a period of more than 18 months and outcome was always uneventful. DISCUSSION Kingella kingae is usually present in the nasopharyngeal mucosa and spreads in the blood due to various infections. Different types of Kingella kingae infection have been reported with a large frequency of osteoarticular infection. CONCLUSION This type of infection does not present any unusual characteristics as compared to other osteoarticular infections. Because of its antibiotic sensitivity treatment duration could be reduced. Kingella kingae is a fragile microbe and its culture is often difficult; therefore, it is important to use blood culture tubes to inoculate joint fluid and bone samples.
Collapse
Affiliation(s)
- S Abuamara
- Clinique chirurgicale infantile, hôpital Charles-Nicolle, Rouen, France
| | | | | | | | | | | | | |
Collapse
|
27
|
|
28
|
Gunnarsson RK, Holm SE, Söderström M. The prevalence of potentially pathogenic bacteria in nasopharyngeal samples from individuals with a long-standing cough-clinical value of a nasopharyngeal sample. Fam Pract 2000; 17:150-5. [PMID: 10758078 DOI: 10.1093/fampra/17.2.150] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A long-standing cough is a common cause for visits to a GP. If the patient also has a respiratory tract infection, one of the concerns of the doctor is to decide if the cough is caused by an underlying bacterial infection. OBJECTIVES Our aim was to investigate whether a nasopharyngeal sample, obtained in routine medical practice, could yield information about the aetiology of a long-standing cough in patients with a respiratory tract infection. METHODS The prevalence of potentially pathogenic bacteria (Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis) in nasopharyngeal swab samples from 618 healthy individuals was compared with that from 236 patients with a respiratory tract infection and long-standing cough (>9 days) of the same age in a defined geographical area. RESULTS The proportion of cultures with potentially pathogenic bacteria decreased with age and was 44% among healthy individuals of pre-school age, 13% in schoolchildren and 6% in adults. The corresponding figures for patients with a long-standing cough were 83, 35 and 36%, respectively. All types of potentially pathogenic bacteria were found more frequently in pre-school children and in adults with a long-standing cough compared with healthy individuals of the same age. CONCLUSIONS In patients with a respiratory tract infection and a long-standing cough, where a bacterial infection is suspected on clinical grounds, a nasopharyngeal culture could yield information about the aetiology. If M.catarrhalis is found in pre-school children, or if H.influenzae is found in adults, they are likely to be the aetiological agent.
Collapse
Affiliation(s)
- R K Gunnarsson
- Department of Primary Health Care, Göteborg University and Department of Clinical Bacteriology, Umeå University, Sweden
| | | | | |
Collapse
|
29
|
Joki-Erkkilä VP, Hietaharju A, Numminen J, Dastidar P, Puhakka H. Multiple cranial nerve palsies as a complication of infectious mononucleosis due to inflammatory lesion in jugular foramen. Ann Otol Rhinol Laryngol 2000; 109:340-2. [PMID: 10737322 DOI: 10.1177/000348940010900319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- V P Joki-Erkkilä
- Department of Otorhinolaryngology-Head and Neck Surgery, Tampere University Hospital, Finland
| | | | | | | | | |
Collapse
|
30
|
Ricchetti A, Lacroix JS, Kaiser L, Morabia A, Stalder H, Auckenthaler R, Terrier F, Hirschel B, Khaw N, Lew D. [Symptoms and clinical and radiological signs predicting the bacterial origin of acute rhinosinusitis]. Schweiz Med Wochenschr 2000; Suppl 125:27S-29S. [PMID: 11141933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
A minority of patients with common cold and upper respiratory tract infections have a bacterial infection and may benefit from antibiotic therapy. The present analysis set out to determine whether there were clinical symptoms or signs which could help the clinician to identify a subset of patients with moderate forms of acute rhinosinusitis who are infected with pathogenic bacteria. Detailed clinical history and medical examination were obtained from 265 patients (mean age 35 years, 138 females and 127 males) presenting symptoms of upper respiratory tract infections but no fever above 38 degrees C. The presence of three pathogenic bacteria (S. pneumoniae, H. influenzae or M. catarrhalis) was determined in all patients by culture of nasopharyngeal secretions. Aggravating factors for severity of rhinosinusitis, such as severe nasal obstruction, inferior and/or middle turbinate hypertrophy, oedema of the middle meatus mucosa and septal defects, were not associated with the presence of bacteria. Pathogenic bacteria were found in 77 patients (29%). The clinical signs and symptoms which were significantly associated in a multivariate model with the presence of bacteria included facial pain (p < 0.003), coloured nasal discharge (p < 0.003) and radiological maxillary sinusitis (complete opacity, air-fluid level or mucosal thickening greater than 10 mm) (p < 0.002). This, the best predictive model, had a sensitivity of 69% and a specificity of 64% and therefore could not be used either as a screening tool or as a diagnostic criterion for bacterial rhinosinusitis. We conclude that signs and symptoms of acute rhinosinusitis in patients with a mild to moderate clinical presentation are poor predictors of the presence of bacteria. In agreement with previous studies, culture of nasopharyngeal secretions may identify patients who would benefit from antibiotic treatment. Thus, antibiotic therapy should not be prescribed in the absence of bacteriological evidence.
Collapse
Affiliation(s)
- A Ricchetti
- Unité de rhinologie, Clinique et Policlinique d'oto-rhino-laryngologie, Hôpitaux Universitaires de Genève, 24, rue Micheli-du-Crest, CH-1211 Genève 14
| | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Noris-García E, Dorta-Contreras AJ, Escobar-Pérez X, González-Hernández M. [Haptoglobin in cerebrospinal fluid as a marker of infectious process in central nervous system]. Rev Neurol 1999; 29:117-20. [PMID: 10528321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
INTRODUCTION Haptoglobin is a transport protein and protects organism against iron loss and it should be involved in central nervous system infectious process. PATIENTS AND METHODS Simultaneous serum and cerebrospinal fluid were obtained of 39 pediatric patients, 14 suffering from viral meningoencephalitis and 25 from bacterial meningoencephalitis. Five control cases were examined too. Haptoglobin, IgG and albumin were quantified in both fluids by radial immunodiffusion. Haptoglobin cerebrospinal fluid/serum ratio, haptoglobin index and haptoglobin/IgG index were calculated. Local IgG intrathecal synthesis was determined by reibergram. RESULTS Haptoglobin index was higher not statistically significant in viral meningoencephalitis in comparison with bacterial disease but both were statistically significant with respect to control group. Increased haptoglobin/IgG index were statistically significant in bacterial meningoencephalitis in relation with viral meningoencephalitis. There were no association between haptoglobin and polymorphonuclear cells count and globular sediment speed. CONCLUSION Haptoglobin should be considered a relevant marker of central nervous system infectious process.
Collapse
Affiliation(s)
- E Noris-García
- Laboratorio de Imnunología, Hospital Pediátrico San Miguel del Padrón, La Habana, Cuba.
| | | | | | | |
Collapse
|
32
|
Abstract
OBJECTIVE To evaluate evidence-based data on adjunctive glucocorticoid therapy in central nervous system bacterial infections. DESIGN A literature review of studies, particularly controlled trials, that have evaluated dexamethasone therapy for acute bacterial meningitis and glucocorticoid therapy for tuberculous meningitis. MAIN OUTCOME MEASURES Clinical outcomes were mortality and morbidity rates. Morbidity involved sensorineural hearing loss and other neurologic deficits (motor or behavioral disturbances, epilepsy, cranial nerve palsy, hydrocephalus, and psychomotor retardation). RESULTS The evidence-based data support adjunctive dexamethasone therapy for children with Haemophilus influenzae meningitis. However, the optimal duration of therapy is not defined. Data are supportive but not conclusive that dexamethasone benefits meningitis caused by other bacterial agents and meningitis in adults. The evidence-based data are supportive but not conclusive that adjunctive glucocorticoid therapy benefits patients with tuberculous meningitis, particularly those with more severe infection. CONCLUSIONS Although adjunctive glucocorticoid therapy may be beneficial in both acute bacterial meningitis and more severe tuberculous meningitis, there are conclusive data only for H influenzae meningitis in children. For acute bacterial meningitis, further studies are needed to clarify the optimal duration of dexamethasone therapy (2 vs 4 days), whether this therapy should be used routinely for adults with meningitis, and whether it should be used for pathogens other than H influenzae. For tuberculous meningitis, further studies are needed to provide conclusive evidence of benefit.
Collapse
Affiliation(s)
- P K Coyle
- Department of Neurology, State University of New York at Stony Brook, 11794, USA.
| |
Collapse
|
33
|
Pons Odena M, González Pascual E, Ros Viladoms J, Gené Giralt A, May Llanas E, Huguet Carol R. [Osteoarticular infection by Kingella kingae: two case reports]. An Esp Pediatr 1999; 50:491-4. [PMID: 10394189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- M Pons Odena
- Unidad Integrada Hospital Clínic-Sant Joan de Déu, Universidad de Barcelona
| | | | | | | | | | | |
Collapse
|
34
|
Neumayer U, Schmidt HK, Mellwig KP, Kleikamp G. Moraxella catarrhalis endocarditis: report of a case and literature review. J Heart Valve Dis 1999; 8:114-7. [PMID: 10096493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
A 53-year-old man developed severe acute systemic illness three weeks after an upper respiratory tract infection. Serial blood cultures grew Moraxella catarrhalis. During antibiotic treatment, fever and infectious parameters disappeared, but severe aortic regurgitation developed. Aortic valve replacement was performed, during which extensive destruction of the aortic valve was noted. Endocarditis due to M. catarrhalis is very rare with, to our knowledge, only six cases having been reported to date. M. catarrhalis is a normal commensal of the upper respiratory tract, but in unpredictable circumstances can become an important pathogen. Bacteremia due to this organism therefore requires prompt treatment, as serious organ complications, including endocarditis, can occur.
Collapse
Affiliation(s)
- U Neumayer
- Department of Cardiology, Ruhr-University Bochum, Heart Center NRW, Bad Oeynhausen, Germany
| | | | | | | |
Collapse
|
35
|
Affiliation(s)
- J Amir
- Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tikva.
| | | |
Collapse
|
36
|
Geisler WM, Markovitz DM. Septic arthritis caused by Neisseria sicca. J Rheumatol Suppl 1998; 25:826-8. [PMID: 9558202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
37
|
Abstract
CASE REPORT A 2-year-old child, non immunodeficient, presented with septicemia due to Kingella kingae successively complicated by meningitis, arthritis of one knee and endocarditis. Outcome was favourable after a long and adjusted antibiotherapy, involving in particular for the endocarditis ceftriaxone (100 mg/kg/d) and amikacin (20 mg/kg/d) during 3 weeks, then amoxicillin per os (200 mg/kg/d) during 3 weeks. CONCLUSIONS Bacteriologic characteristics of the bacteria, the culture of which requires medium base with additional nutrient are reviewed. The tropism of Kingella kingae is essentially osteoarticular and cardiac as shown by the cases reported in the literature. Its susceptibility to antibiotics explains the frequent favourable outcome.
Collapse
Affiliation(s)
- H Sarda
- Service de pédiatrie, hôpital Victor-Dupouy, Argenteuil, France
| | | | | | | | | | | |
Collapse
|
38
|
Abstract
A case of lumbar facet joint infection associated with abscesses of the paraspinal muscles and the epidural space is presented. The infection did not respond to intravenous antibiotic therapy and resolved only after incision and drainage of the epidural space, involved facet joint, and paraspinal musculature. Magnetic resonance imaging, which showed a widened facet joint, epidural abscess, and paraspinal involvement, aided in diagnosis and preoperative planning. This condition is rare, and this report outlines some clinical characteristics of the infection and the usefulness of magnetic resonance imaging in visualizing the extent of the infection.
Collapse
Affiliation(s)
- M S Baltz
- Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston 29425, USA
| | | | | |
Collapse
|
39
|
Flores J, Lloret A, Bellver F, Segarra C, Monzo E. [Infectious endocarditis by Neisseria subflava in two HIV drug users]. An Med Interna 1997; 14:267-8. [PMID: 9235111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
40
|
Iriyama T, Sugimura S, Hattori Y, Senga M, Takeda I, Kanou H, Ozawa K, Matsuyama T. [A case of acute mediastinitis with pyothorax secondary to peritonsillar abscess]. Kyobu Geka 1997; 50:78-81. [PMID: 8990816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 41-year-old man was admitted to a hospital elsewhere because of tonsillitis with high grade fever. On the 9th day of hospitalization, the patient complained of dysphagia and dyspnea. A chest X-ray film and a CT scan showed right pleural effusion and pericardial effusion, and he was referred to our hospital. Immediately after admission, he underwent pericardiotomy to relieve cardiac tamponade, and a right thoracic tube was inserted for pyothorax. Next day, mediastinal drainage was accomplished through a cervical incision and a right thoracotomy. Eight drainage tubes were left in place. Cultures revealed alpha-Streptococcus, Neisseria and group F Streptococci. Continuous closed irrigation with diluted Isodine (povidone iodine) solution was performed. The last extubation of the drainage tube was done on the 140th day after operation. He was cured and discharged on the 162nd day after operation. In patients with extensive acute mediastinitis secondary to deep cervical infection, early complete mediastinal drainage via a cervical and a transthoracic incision is essential.
Collapse
Affiliation(s)
- T Iriyama
- Department of Thoracic Surgery, Fujita Health University School of Medicine, Aichi, Japan
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Rozenberg V, Chauveau P, Gryman R, Clavier H. [Neisseria Sicca endocarditis disclosed by multiple organ failure syndrome]. Arch Mal Coeur Vaiss 1996; 89:1689-93. [PMID: 9137737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The authors report a case of Neisseria sicca endocarditis presenting with multiple organ failure in a 33 year old intravenous drug user. The diagnosis was confirmed by transthoracic and transoesophageal echocardiography showing vegetations on the aortic valve and three blood cultures positive for Neisseria Sicca. Massive aortic regurgitation occurred on the 4th day. The patient died of complications of intracerebral haematomas before surgical intervention. Contrary to pathogenic Neisseria gonorrhoeae and meningitides, saprophytic Neisseria, including Neisseria sicca, are commensal organisms of the upper respiratory tract. They are exceptionally rare causes of endocarditis. A review of the literature from the era of antibiotic therapy, found about thirty cases of saprophytic Neisseria endocarditis of which only five were due to Neisseria sicca. The clinical characteristics were the young age, the mainly left heart valve disease and the high incidence of cerebrovascular accidents. The originality of this case was the exceptionally rare involvement of this organism and the multiplicity of the extracardiac manifestations, especially renal and neurological.
Collapse
Affiliation(s)
- V Rozenberg
- Service de réanimation polyvalente, Centre hospitalier, Montreuil
| | | | | | | |
Collapse
|
42
|
Len O, de Otero J, Almirante B, Pigrau C, Planes AM, Pahissa A. [Bacteremia caused by Neisseria subflava and neutrocytic ascites in a female patient with hepatic cirrhosis]. Enferm Infecc Microbiol Clin 1996; 14:334-5. [PMID: 8744381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
|
43
|
Affiliation(s)
- D W Johnson
- Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | | | | | | |
Collapse
|
44
|
Abstract
Fifty-eight cases of bacteremia due to Moraxella catarrhalis, including seven that occurred in patients treated at our facilities, are analyzed. The host's medical history plays a major role in the presentation and outcome of M. catarrhalis bacteremia. Bacteremia is typically accompanied by pneumonia in adults with underlying respiratory disease. Many neutropenic patients do not manifest a focus of infection; in contrast, the source identified in healthy, immunocompetent patients is usually the upper airway or the ears. In the recent literature, it has been reported that a rash is typically absent in adults with bacteremic pneumonia and in immunocompetent hosts and that only some neutropenic patients have a rash. The prognosis is grave for patients with endocarditis and for patients with immunoglobulin deficiency or neutropenia not related to a hematologic malignancy. In addition, mortality is substantial among bacteremic patients with respiratory conditions or other chronic debilities, especially when respiratory copathogens are present. The prognosis is good for febrile neutropenic patients with underlying leukemia or lymphoma when the neutropenia resolves. When healthy, immunocompetent individuals are affected with M. catarrhalis bacteremia, their presentations range from self-limited febrile illness to life-threatening disease.
Collapse
Affiliation(s)
- J P Ioannidis
- Department of Medicine, New England Medical Center Hospitals, Boston, Massachusetts 02111, USA
| | | | | | | |
Collapse
|
45
|
Lepper AW, Atwell JL, Lehrbach PR, Schwartzkoff CL, Egerton JR, Tennent JM. The protective efficacy of cloned Moraxella bovis pili in monovalent and multivalent vaccine formulations against experimentally induced infectious bovine keratoconjunctivitis (IBK). Vet Microbiol 1995; 45:129-38. [PMID: 7571364 DOI: 10.1016/0378-1135(94)00123-e] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Calves were vaccinated with cloned Moraxella bovis pili of serogroup C (experiment 1) or B (experiment 2) either as a monovalent formulation or as part of a multivalent preparation with pili of six other serogroups. Within 4 weeks of the second vaccine dose vaccinated calves and non-vaccinated controls were challenged via the ocular route with either virulent M. bovis strain Dal2d (serogroup C) or M. bovis strain 3WO7 (serogroup B) in experiments 1 and 2, respectively. Calves vaccinated with multivalent vaccines had significantly lower antibody titres than those vaccinated with monovalent preparations. Nevertheless, the levels of protection against infectious bovine keratoconjunctivitis (IBK) achieved with multivalent vaccines were 72% and 83% for the groups challenged with M. bovis strains of serogroups B and C, respectively. The serogroup C monovalent vaccine gave 100% protection against experimentally induced IBK and M. bovis isolates cultured from the eyes 6 days post-challenge were identified as belonging solely to serogroup C. Unexpectedly, only 25% protection was achieved against homologous strain challenge of calves that received the monovalent serogroup B vaccine. Furthermore, the majority of M. bovis isolates recovered from calves in this group belonged to serogroup C, as did half of those isolates cultured from the multivalent vaccinates. The remaining bacterial isolates from the latter group, together with all isolates from the non-vaccinated controls, belonged to serogroup B. Results are consistent with the hypothesis that derivatives of the serogroup B challenge inoculum had expressed serogroup C pilus antigen within 6 days of the challenge, possibly as a result of pilus gene inversion occurring in response to the presence of specific antibody in eye tissues and tears.
Collapse
Affiliation(s)
- A W Lepper
- CSIRO Division of Animal Health, Animal Health Research Laboratory, Parkville, Vic., Australia
| | | | | | | | | | | |
Collapse
|
46
|
|
47
|
Hol C, Van Dijke EE, Verduin CM, Verhoef J, van Dijk H. Experimental evidence for Moraxella-induced penicillin neutralization in pneumococcal pneumonia. J Infect Dis 1994; 170:1613-6. [PMID: 7996007 DOI: 10.1093/infdis/170.6.1613] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Resistance of microorganisms to antimicrobial agents is an increasing problem in the treatment of infectious diseases. In mixed infections, an interesting development can arise when one organism protects another from being killed by an antibiotic. Unfortunately, in the case of respiratory tract infections, experimental evidence of this development is poor. In this study, mice intranasally infected with a lethal number of pneumococci and treated with a curative dose of penicillin or amoxicillin died from pneumococcal pneumonia when they were coinoculated with beta-lactamase-producing Moraxella catarrhalis. beta-lactamase-negative M. catarrhalis did not show a similar indirect pathogenic effect. Treatment with a combination of amoxicillin and the beta-lactamase inhibitor clavulanic acid was not affected by beta-lactamase-producing M. catarrhalis. These findings help explain antibiotic failure in respiratory tract infections, even though the causative microorganism is sensitive to the antibiotic in vitro.
Collapse
Affiliation(s)
- C Hol
- Eijkman-Winkler Institute for Medical and Clinical Microbiology, Utrecht University, Netherlands
| | | | | | | | | |
Collapse
|
48
|
Rosón B, Santín M, García del Muro J, Carratalá J. [Bacteremial pneumonia caused by Moraxella catarrhalis in a neutropenic patient]. Enferm Infecc Microbiol Clin 1994; 12:418-9. [PMID: 7981303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
49
|
|
50
|
Epelbaum S, Laurent C, Morin G, Laurans G, Piussan C. [Neisseria mucosa endocarditis complicated by intracerebral aneurysm]. Arch Fr Pediatr 1993; 50:231-3. [PMID: 8338418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Serious complications, such as emboli and mycotic aneurysms, are still frequent in documented cases of infective endocarditis. Infecting organisms other than Streptococcus viridans and Staphylococcus are becoming more common. CASE REPORT A 8 year-old girl was admitted because of a sudden pain in the right calf followed by complete disability. She had low-grade fever and presented with a moderate heart murmur with no sign of congestive heart failure, a severe pain at palpation of her calf with no Homans sign; she had many dental caries. Laboratory data indicated leukocytosis with increased percentage of polymorphonuclear cells and increased sedimentation rate. Ultrasonography of the calf showed laceration of the muscle with blood suffusion. Echocardiography showed vegetations involving the mitral valve. Intravenous antibiotic therapy with penicillin G and netilmicin was instituted, but mitral insufficiency appeared 7 days later while the fever persisted. At that time, the brain CT scan showed ischemic lesions, while angiography showed several mycotic aneurysms. Neisseria mucosa was recovered from the 5 initial blood cultures 16 days after the onset, and penicillin G was replaced by ampicillin. A second vegetation involving the aortic valve was seen a few days later, and a recent arterial embolism to the right leg was suspected because fever and pain reappeared. The brain ischemic lesions gradually disappeared and a second angiography performed 3 months after the first showed that all but one large mycotic aneurysm had disappeared; this last aneurysm was excised. Four years later, the child is in good health without any neurological sequelae but having mitral insufficiency. CONCLUSION This girl presented with classical complication of infective endocarditis due to Neisseria mucosa, a saprophytic organism of the oral cavity. This is the second report of such an infection in children.
Collapse
Affiliation(s)
- S Epelbaum
- Service de Pédiatrie 1, CHUR d'Amiens, Hôpital Nord
| | | | | | | | | |
Collapse
|